Provider Demographics
NPI:1629352208
Name:KOPS, SANDRA KRAEUTER (PHD, RD, CD-N)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:KRAEUTER
Last Name:KOPS
Suffix:
Gender:F
Credentials:PHD, RD, CD-N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 BRINSMADE RD
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06514-1904
Mailing Address - Country:US
Mailing Address - Phone:203-288-2535
Mailing Address - Fax:
Practice Address - Street 1:55 BRINSMADE RD
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06514-1904
Practice Address - Country:US
Practice Address - Phone:203-288-2535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-30
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001054133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered